Adult Congenital Heart Disease: A Growing Epidemic

Ávila, Pablo; Mercier, Lise‐Andrée; Dore, Annie; Marcotte, François; Mongeon, François‐Pierre; Ibrahim, Réda; Asgar, Anita W.; Miró, Joaquim; Andelfinger, Grégor; Mondésert, Blandine; Guise, Pierre de; Poirier, Nancy; Khairy, Paul

doi:10.1016/j.cjca.2014.07.749

Cited by 91 publications

(52 citation statements)

References 92 publications

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“…Survival into adulthood is now >90% and there are already twice as many adult patients with CHD (ACHD) than paediatric patients with CHD 1. In addition, life expectancy of patients with ACHD has improved considerably, bringing up late complications, namely heart failure and arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Management of supraventricular arrhythmias in adults with congenital heart disease

Wasmer

Eckardt

2016

Heart

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Supraventricular arrhythmias are a frequent complication in adults with congenital heart disease (ACHD). The prevalence increases with time since surgery, complexity of the underlying defect, type of repair and older age at surgery. Arrhythmias are the most frequent reason for hospital admission and along with heart failure the leading cause of death. The arrhythmia-associated increase in morbidity and mortality makes their management a key task in patients with ACHD. Intra-atrial re-entry is the most frequent arrhythmia mechanism. Less common arrhythmia mechanisms are supraventricular tachycardias in the presence of an accessory pathway, atrioventricular nodal re-entrant tachycardia or focal tachycardias. Patient management includes stroke prevention, acute termination and prevention of arrhythmia recurrence. Acute treatment depends on patients' symptoms. In cases of haemodynamic instability, immediate cardioversion is warranted. For stable patients, acute treatment includes rate control and termination by antiarrhythmic drugs or electrical cardioversion. Following a symptomatic arrhythmia, catheter ablation or treatment with antiarrhythmic drugs is recommended to prevent recurrences. Advances in mapping and ablation technology are now associated with high success rates of catheter ablation. In patients with a complex substrate recurrence rates of 50% remain high. However, in the presence of side effects and complications associated with long-term antiarrhythmic drug therapy, redo procedures are encouraged by current guidelines.

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Section: Introductionmentioning

confidence: 99%

Management of supraventricular arrhythmias in adults with congenital heart disease

Wasmer

Eckardt

2016

Heart

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“…12 SCD, primarily due to malignant VAs occurring during the third to fifth decade of life, is a leading cause of death in adult patients with CHD. 5 ICDs successfully treat life-threatening VAs in this population.…”

Section: Introductionmentioning

confidence: 99%

The Use of Implantable Cardioverter-defibrillators in the Prevention of Sudden Cardiac Death: A Focus on Congenital Heart Disease and Inherited Arrhythmia Syndromes

Goldstein

Ward

Al‐Khatib

2017

J Innov Cardiac Rhythm Manage

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“…Indeed, the prevalence of adult congenital heart disease (ACHD) worldwide has exceeded that in the paediatric population [1]. The majority of patients would have undergone surgical or catheter interventions, often multiple, before reaching adulthood and, in several cases, further procedures are required in adulthood to correct haemodynamically significant residual lesions or manage cardiac arrhythmias.…”

Section: Introductionmentioning

confidence: 99%

Congenital Heart Disease has no Negative Impact on Educational Achievements and Employment among Maltese Adult Patients under Clinical Follow-Up

Caruana¹,

Grech²

2016

ICFJ

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Background: Most children born with congenital heart disease (CHD) nowadays survive into adulthood. The aim of this study was to investigate the potential impact of CHD on educational achievements and employment in Maltese adult patients.Methods: A bespoke self-reporting questionnaire based on the 2008 European Health Interview Survey (EHIS 2008) was distributed to 162 consecutive Maltese adult congenital heart disease (ACHD) patients at time of hospital follow-up for the 1-year period May 2013-May 2014. Education and employment in the ACHD cohort were compared with those from 372 randomly-selected age- and sex-matched EHIS 2008 responders (general population cohort). Chi-squared and Fisher Exact tests were used for categorical variables, and Mann-Whitney U test was applied to numerical variables.Results: There were 125 ACHD responders (65 males, mean age 30.64±12.80 years). Nineteen patients had mild CHD, 85 had moderate lesions and 21 had severe disease. Patients with moderate/severe CHD had undergone significantly more cardiac procedures (mean 1.79; 95% CI 1.56,2.02) compared to patients with mild disease (mean 0.68; 95% CI 0.40,0.96) (p<0.001). There were no significant differences in educational achievements, employment rate or working patterns between the 2 cohorts, but significantly more ACHD patients had higher-skilled occupations (82.1%) compared to the general population (67.5%; p=0.01), with this difference being restricted to male subjects. There were no significant differences in education and employment upon comparison of patients with mild and moderate/severe disease.Conclusions: This study suggests that, in Malta, ACHD has no negative impact on educational achievements and employment.

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Adult Congenital Heart Disease: A Growing Epidemic

Cited by 91 publications

References 92 publications

Management of supraventricular arrhythmias in adults with congenital heart disease

Management of supraventricular arrhythmias in adults with congenital heart disease

The Use of Implantable Cardioverter-defibrillators in the Prevention of Sudden Cardiac Death: A Focus on Congenital Heart Disease and Inherited Arrhythmia Syndromes

Congenital Heart Disease has no Negative Impact on Educational Achievements and Employment among Maltese Adult Patients under Clinical Follow-Up

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